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Published on: May 7, 2015
Intellectual development of patients with biliary atresia who underwent living donor liver transplantation in infancy
Seiichi Kawabata1, Rieko Sakamoto2, Keiichi Uto1
1Department of Pediatric Surgery and Transplantation, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Insights
Pediatric liver transplant recipients for biliary atresia show lower intellectual functioning. This study found significantly lower mean full scale intelligence quotient scores in school-aged children post-transplant compared to the general population.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Neurodevelopmental Pediatrics
- Transplantation Medicine
Background:
- The long-term impact of pediatric liver transplantation on cognitive development remains under-researched.
- Biliary atresia is a leading indication for liver transplantation in infants.
- Understanding intellectual outcomes is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate the intellectual development of school-aged children following living donor liver transplantation for biliary atresia.
- To identify potential predictors of intellectual performance in this patient cohort.
Main Methods:
- Administered the Wechsler Intelligence Scale for Children-fourth edition to 20 pediatric liver transplant survivors (≥5 years post-transplant).
- Defined borderline full scale intelligence quotient as ≤85.
- Compared pre-, peri-, and postoperative data between patients with normal vs. borderline intellectual functioning.
Main Results:
- Mean full scale intelligence quotient was significantly lower (91.8) than the general population (100.0, p=0.026).
- 35% (7 of 20) of patients exhibited borderline intellectual functioning (≤85).
- No specific pre-, peri-, or postoperative factors predicted borderline intellectual performance.
Conclusions:
- This study provides the first evidence of reduced mean intellectual quotient in school-aged children after living donor liver transplantation for biliary atresia.
- The findings highlight the need for neurodevelopmental monitoring in pediatric liver transplant recipients.
- Further research is warranted to explore the underlying causes and potential interventions for cognitive deficits.
Background:
The impact of pediatric liver transplantation on intellectual development has yet to be determined. We investigated the intellectual outcomes of school-aged patients after living donor liver transplantation for biliary atresia in infancy.
Methods:
The Wechsler Intelligence Scale for Children-fourth edition test was administered to 20 patients who survived [Formula: see text] 5 years after living donor liver transplantation. Borderline full scale intelligence quotient was defined as ≤ 85. Pre-, peri-, and postoperative data were compared between patients with > 85 and ≤ 85 to identify predictive factors of borderline performance.
Results:
The one-sample t test demonstrated that the mean full scale intelligence quotient of patients after transplantation for biliary atresia was significantly lower than that of the general population (91.8 vs. 100.0, p = 0.026) and 7 (35%) were classified as intellectual borderline functioning. Multivariable logistic regression models were unable to identify any factors predictive of full scale intelligence quotients of ≤ 85.
Conclusion:
This is the first study to indicate that the mean full scale intelligence quotient among school-aged patients who underwent living donor liver transplantation for biliary atresia in infancy is significantly lower than that of the general population.
